Now, as he’s said before, London Stabbie yields to no one in his respect for the National Health Service and its doctors, nurses, and supporting staff. They do a tremendous job in the face of massive government cuts, insensitive patients, and inadequate facilities.
However (Stabbie is certain you knew there was a “however”), the events of this last weekend have been very hard on Stabbie and nearly shook his faith in the NHS to the core.
On Thursday of last week, Stabbie received a letter informing him that a bed had been found for his procedure and that he would be called on Sunday to be told where to go. Besides the fact that Stabbie is up for more than one procedure, the letter itself was misleading, making Stabbie think that he’d neglected to confirm his appointment. So Stabbie’s first target is the person who wrote that form letter. As Stabbie is not particularly keen to shed any blood, what he does want to do is cut that person’s computer up into tiny little pieces and restrict him or her to writing with a quill pen. It might allow him to actually think about what he’s writing.
The call finally came at about 5pm on Sunday. Stabbie was to report to Vlad Dracula ward (the name has been changed to protect the guilty) at 7pm. Stabbie and his partner duly reported there and then Stabbie was left alone.
The procedure was an angioplasty of the leg, to try to improve the circulation to Stabbie’s foot. While this procedure is carried out under local anesthesia, the patient is not allowed to eat or drink anything from midnight the previous day. Normally they would have hooked Stabbie up to a combined glucose and insulin drip from midnight until the operation. This is suboptimal, as Stabbie would have had to be woken up each and every hour for a blood sugar check. So Stabbie convinced the nurse to allow him his usual dose of long-lasting insulin before bedtime and only to hook up the machine in the morning.
Vlad Dracula ward has about 12 beds in the men’s section. Stabbie’s neighbour was a big man (around 6’5″ tall and a bit heavy). When Stabbie tried to fall asleep (in the very inadequate hospital bed) his neighbour began to snore. It was probably a 90 decibel snore. This was not good. So when the snoring ceased, Stabbie was quite happy until it became clear that his neighbour has sleep apnea. After 30 seconds or so his neighbour’s breathing and snoring would begin again, starting with a phenomenal sound of sucking-in air. Now Stabbie occasionally snores (but not often), and Stabbie’s partner also occasionally snores (but not often), but this kind of snoring puts both Stabbie and his partner to shame. Stabbie is not one to cut up people who can’t help being annoying, but perhaps an emergency tracheotomy for this gentleman might be warranted. Stabbie will lend the doctor his knife for the occasion.
Monday dawned, and Stabbie was denied breakfast. Hours passed—Stabbie was then denied lunch. However, Stabbie could smell the food odours wafting their way from the adjoining cubicles. Fasting makes hospital food seem to be pure ambrosia, but it was an ambrosia that Stabbie was denied.
Finally the nurse came over (quite a cute male nurse—Stabbie was quite smitten) and said that he’d be taken down to the angioplasty lab at around 4pm. He was still connected to the glucose/insulin pump.
The angioplasty was interesting—Stabbie could see his arteries coloured on the X-ray picture as the surgeon threaded the wire down there. When the balloon was inflated, Stabbie could not only see it on the monitor, but feel it in his calf. It was like an electric shock. The operation took around 3/4 hour, and Stabbie was then returned to Vlad Dracula ward.
Of course, by this time the hot dinner was over, so Stabbie was forced to eat a sandwich. Quite inadequate. And Stabbie was also forced to lie flat for two hours to keep strain off the wound. Kings does not suture the arterial hole they use to feed in the wire and balloon, so the surgeon applies a complicated plaster and then pressed down on Stabbie’s groin for ten minutes. You may believe Stabbie when he says that it was not as erotic as the words would lead one to believe.
The end result was that 1 out of 3 of Stabbie’s leg arteries could be cleared. The other two are irretrievably calcified. Stabbie may have an arterial bypass if the quacks think that more blood is necessary. However, he noticed that his foot is pinker now.
After lying in bed for two hours, Stabbie wished to “spend a penny”, in the old English parlance. The nurse refused to let Stabbie walk the 20 or so steps to the loo; she brought in a commode and closed the curtain. Stabbie was not happy. We too shall draw the curtain over Stabbie’s Monday evening. Suffice it to say that Mr. Buzz-Saw in the next cubicle was in fine voice that evening and Stabbie did not get a whole lot of sleep then either.
Tuesday morning dawns! Stabbie is to be discharged today! Hurray! But first, Stabbie’s leg and foot have to be seen by the vascular surgical team to ensure that everything was working as it ought. Stabbie had originally had an appointment at the foot clinic for the Monday. However, then he got the letter, he called the clinic and tried to arrange it for the next Thursday, as he would be otherwise engaged on the Monday getting wires shoved down his groin and balloons inflated inside his arteries. The receptionist offered a Tuesday appointment. Stabbie thought, “Oh, I’ll be right here so Tuesday will be fine; I’ll just have to walk downstairs.” and took the appointment.
At around 10:30am Stabbie left Vlad Dracula ward, telling the staff that he was going to the Foot Clinic and would be back as soon as possible. When he got down to the clinic, the receptionist could not find his notes, and much running around ensued. Stabbie, meanwhile, waited in the clinic for 2-1/2 hours while everything was sorted out.
It transpires, when Stabbie is finally seated in an examining chair in the clinic, that the vascular team had tried to visit him in Vlad Dracula ward, was told that he had gone to the foot clinic, and decided not to call Stabbie back but to see him when they got down to the clinic.
The head vascular surgeon has a really good bedside manner and pronounced Stabbie’s operation a qualified success, as his foot is pinker and the pulse better. The podiatrist then poked around Stabbie’s foot with his scalpel at the ready, and said, “Oh, your ulcer’s healed now; there’s just a scab over it.”
So that was good news. However, worse news was to come. The nurse at the clinic couldn’t administer my antibiotic (IV) because he was off sick that day. The podiatrist told Stabbie to go back to Vlad Dracula ward and tell them to administer it. He also told Stabbie to return in 3 weeks. That’s almost a record. But the good news ends here.
When Stabbie got back to Vlad Dracula ward, he discovered that his hot lunch had been removed and the only thing he could eat was a ham sandwich with English mustard. On white. Oh, joy!
The nurse prepared Stabbie’s antibiotic (it’s a powder that must be diluted in water then injected into a drip bag to be dripped into Stabbie’s PICC line. Then she came back and informed Stabbie, “I can’t administer your antibiotic although I’ve prepared it; your drug chart is missing.” Stabbie suggested that the nurse find a doctor (it’s surprising how difficult it is to find a doctor in a hospital, but Stabbie digresses…) but she said that was totally impossible and Stabbie couldn’t have his antibiotic Tuesday.
After a bit of searching they found Stabbie’s drug chart tucked into the folder of the patient to Stabbie’s left. The nurse could then start the IV. But Stabbie’s got a little list, and the numpty who filed his drug chart in the folder for the next bed is on that list. Stabbie will content himself with taking that person’s medical diploma and slicing it into confetti with Stabbie’s dagger. That person obviously needs a refresher course in filing, and having to prove his qualifications again may make him think carefully before taking someone else’s drug chart.
The IV drip ended, and meanwhile the staff on Vlad Dracula ward were responsible for getting Stabbie’s repeat prescription for antibiotics. A jobsworth from the Pharmacy department hectored Stabbie to tell her how much insulin he takes and when. Stabbie protested that everyone who needed to know this information already did. “We need it for our records.” she responded coldly, and wouldn’t go away until Stabbie gave her the information. It went on a letter that no one will read.
Somehow Stabbie thinks that using his blade on jobsworths is unworthy of the blade. In a way, it stains it with blood that it should never touch. So Stabbie will not physically hurt the jobsworth. However, Stabbie would be pleased if the jobsworths in the Pharmacy Department were classed with the telephone sanitisers and telemarketers of the Hitchhiker’s Guide to the Galaxy when the revolution comes.
The jobsworth left Stabbie at 3 pm, saying that his antibiotics would be up at Vlad Dracula ward in an hour. Stabbie settled down to a book by Alfred Bester, and finished it by 5 pm as it was an interesting but easy read. No antibiotics. The nurses studiously avoided looking at Stabbie, all packed in his cubicle and ready to go home. So Stabbie went to the nurses’ desk and enquired, politely, when the prescription would be ready so that he could go home. They said that it was coming up right that second. Stabbie went back to his cubicle and fumed.
At 6 pm one of the charge nurses (who was quite cute) came to Stabbie’s cubicle and said, “You have a PICC line?” Stabbie’s short-sleeved shirt revealed the PICC line better than anything, and he just showed his arm to the nurse. Then the nurse said, “We will have to send a fax to the District Nurse to tell her that she has to visit you and after that we’ll give you the antibiotics.”
Stabbie nearly lost his temper. He said, “I have been taking these antibiotics for a month and a half now. I have a good working relationship with the District Nurses and had already arranged for them to start coming again from Wednesday. You do not need to send them a fax; it’s been taken care of. I have been sitting here for three hours. All I want IS MY ANTIBIOTICS and to GO HOME NOW!” Stabbie’s last nerve had been plucked.
The nurse, alarmed at Stabbie’s reaction, brought the bag of antibiotics and other supplies over and quickly went over the paperwork. Stabbie thanked him coldly and started down the corridor leading away from Vlad Dracula ward. The nurse charged after him and asked, “I almost forgot; do you have syringes?” Stabbie fixed him with a stare and said, “All I need is the antibiotics and the saline bags; everything else is provided. Good bye!”
Now Stabbie would normally have thought of eviscerating the poor nursing staff for treating him like this, as well as the pharmacist who lied to him about the timing. But, Stabbie is a forgiving kind of chap, and the nurse (did Stabbie mention he was a Hispanic male nurse?) was very cute. So Stabbie would probably content himself with cutting the shirt, trousers and boxers off the guy and ensuring that pictures were taken for later, private, consumption.
All in all, while the angioplasty did some good and Stabbie’s foot ulcer is nearly healed, Stabbie’s blood pressure probably soared through the top of his head and all his nerves were plucked so hard that they played Dies Irae. Stabbie got home, dropped his bags, and had the first hot meal he’d had since Sunday lunch.
So Stabbie is grateful that the blood supply to his right foot has improved, and he is grateful that the right foot ulcer seems finally to be healing up. But every other part of the stay at Vlad Dracula ward was purest hell, and he hopes that he never has to stay there again, if for no other reason than that the staff will brand him as “difficult” and take every opportunity to ignore him.
You might consider preparing a cleansed version of this account and attempt to set up a meeting with a higher up (preferably a senior doctor and not just an administrator) at that hospital to give them some constructive feedback.
I have considered joining a users’ group for the NHS in Southwark. That might be the best place to start. I think that in the event much of these shenanigans came from unavoidable coincidences (like booking my clinic appointment on the Tuesday).
The pharmacy, on the other hand, has been notorious ever since I’ve been going to Kings for my feet (and probably before). They consistently are slow, understaffed, and unresponsive to patients and staff of the hospital alike. But no one seems to want to do anything about it.
As for meeting a senior doctor at the hospital, the NHS operates differently from US medical facilities. The doctors do not run the hospital. Lay jobsworths do. Everyone at the hospital I’ve discussed this with has shrugged his or her shoulders and confessed that there is nothing to be done.
MY, my, my…what an ordeal!
Mucho HUGS and Kisses!
I thought you’d given up on science fiction. Which Bester, Stars My Destination/Tiger Tiger, or the other one?
The Demolished Man. Fred Pohl recommended it in his blog as one of the best SF novels around. It wasn’t bad.
Oh, dear. I sure hope Stabbie is feeling better today!
Jeez – what a major ordeal! I hope life is returning to normal for Stabbie – feel better soon!